This application addresses the broad Challenge Area (05) Comparative Effectiveness Research, and Specific Challenge Topic, 05AT-102: Comparative Effectiveness Studies of Complementary and Alternate Medicine. Children's Hospital of Michigan/Wayne State University in Detroit annually performs about 3,000 imaging studies such as MRI, CT, and PET scans. While imaging studies are essential to the evaluation and management of children with many chronic and/or complex conditions, they are anxiety provoking and stressful to the children. Majority of children ages 1-12 years require sedation to undergo these lengthy procedures. A large number of patients, especially those with brain tumors, undergo repeated scans. In several instances, multiple doses of sedation medications (administered intravenously) are required at the time of each scan, leading to significant stress and anxiety among the children. Increased sedation doses may result in adverse effects of mediation/sedation, and also result in increased recovery times, length of stay in the hospital, and increased hospital costs. Non-invasive complementary and alternative medicine (CAM) therapies, including passive music therapy, active music therapy, and distraction procedures have been reported in the scientific literature to reduce stress and anxiety in several settings. To our knowledge, no study has compared the effectiveness of these CAM therapies in alleviating stress and reducing (amount, frequency) the need for sedative medications in young children undergoing imaging studies. The primary goal of our study is to compare the effectiveness of three CAM therapies in reducing the level of stress and anxiety in pediatric patients, ages 1-12 years, undergoing sedation for imaging studies and importantly reducing the need for higher doses of sedation medicines. The three CAM therapies to be studied are passive music therapy (listening to music of one's choice via headphones), active music therapy by a certified music therapist, and distraction procedures by a child life specialist. The secondary goals are (a) to compare the effectiveness of these three CAM therapies in reducing the time to recovery resulting from lowering of sedation required, and to determine the cost-effectiveness realized due to the associated reduction in the length of stay in the recovery room following the procedure, and (b) to create 3 new jobs: Research Coordinator, Certified Music Therapist, and Child Life Specialist. This is a 2-year study in which three new jobs will be created with additional effort by 4 faculty members at the WSU in the city of Detroit and the state of Michigan where the unemployment rate of 11.9% is the highest in the country. The job multiplicity factor for this region is 1.95;thus for the 3 new jobs being proposed, 6 new jobs are anticipated to be created as a result of this study. With the ripple effect due to these jobs on revenue generated from spending as well as from taxes at the city, state and national levels, the impact of this project on the economy of the state and nation is significant. PUBLIC HEALTH RELEVANCE: The aim of our study is to compare the effectiveness of three complementary and alternative medicine therapies in reducing the level of stress and anxiety in pediatric patients, ages 1-12 years, undergoing sedation for imaging studies and importantly reducing the need for higher doses of intravenous sedation medicines or multiple sedation medications in these young children. The three therapies to be studied are passive music therapy (listening to music of one's choice via headphones), active music therapy by a certified music therapist, and distraction procedures by a child life specialist. This is a two-year study in which three new jobs will be created with additional effort by four faculty members at the Wayne State University in the city of Detroit, which has been hard hit by the economy and loss of jobs in the state of Michigan where the unemployment rate of 11.9% is the highest in the country. PHS 398/2590 (Rev. 11/07) Page Continuation Format Page